Lower Mortality Rates in High Ranked Hospitals

The researchers from the Harvard School of Public Health (HSPH) calculate that if the lowest performing hospitals had similar patient mortality rates to those of top-performing hospitals, 2,200 fewer elderly Americans would die each year in the surveyed hospitals from acute myocardial infarction (AMI), congestive heart failure (CHF) and pneumonia, three common medical conditions.

“These findings show that these quality indicators, which are widely available on the web, are very helpful in identifying low mortality hospitals,” said Ashish Jha, Assistant Professor of Health Policy and Management at HSPH and lead author of the study.
The researchers set out to determine whether performing well on Hospital Quality Alliance (HQA) measures was associated with lower risk-adjusted mortality rates for AMI, CHF and pneumonia. By adjusting for risk, the researchers made sure that hospitals that took care of sicker patients weren´t penalized.

The researchers looked at HQA performance scores from 3,720 hospitals in 2004-2005. For each hospital, a score was calculated for how it performed treating patients with AMI, CHF and pneumonia. Examples of performance indicators included whether hospitals gave aspirin and beta-blockers at arrival and discharge for AMI and, for pneumonia, how quickly antibiotics were administered.

The results showed that, when compared with hospitals in the lowest quartile, hospitals in the top quartile of performance had nearly one percent lower mortality among patients with AMI, 0.4 percent among patients with CHF and 0.8 among patients with pneumonia. The researchers calculated that 2,200 potential deaths could have been avoided if the hospitals in the bottom quartile had the same mortality rates as those in the highest quartile. “This study really provides an important validation of the HQA efforts and suggests that paying attention to the quality measures matters,” said Jha